Maq’s story
Maq was diagnosed with frontotemporal dementia in 2010 at the age of 54. Here he reflects on how the condition affects his day-to-day life.
The most common symptoms of dementia include difficulties with remembering, thinking and speaking, which get worse over time. However, there are many other possible symptoms, and everyone has their own unique experience of the condition.
Our dementia specialist Admiral Nurses explain the signs and symptoms to be aware of.
Common signs and symptoms of dementia
Dementia is an umbrella term for a range of conditions that affect the brain. There are many different types, subtypes and causes. It is a progressive condition, which means the symptoms always get worse over time.
There is a wide range of possible signs and symptoms of dementia. People may have some or all of them. The common symptoms include memory problems, changes in cognitive ability (thinking, decision-making and problem-solving) and difficulties with communication. Changes in personality and behaviour are also common in some forms of dementia.
The symptoms vary depending on which type of dementia a person has and what stage they are at – early, middle or late.
Please be aware that many dementia symptoms can also be signs of other physical or mental health conditions, for example thyroid problems, menopause, vitamin B12 deficiency, depression, anxiety, work stress or relationship problems. This means that having symptoms of dementia does not mean you definitely have the condition.
However, if you or someone you know are experiencing signs and symptoms of dementia, it is important to see a GP to establish what may be causing them.
Memory problems
People with dementia may experience:
- increasing forgetfulness, particularly with short-term memory – long-term memories may be less affected, especially at first
- difficulty retaining information
- getting lost in places that used to be familiar
- difficulty remembering names and recognising faces
- difficulty remembering where things are; misplacing things frequently or putting them in the wrong place
Changes in cognitive ability
People with dementia may have changes in cognition, such as:
- problems understanding time and place, for example getting up in the middle of the night to go to work even if they are retired; or believing they need to go home when they already at home
- difficulties with decision-making, reasoning and problem-solving
- changes in judgement, for example judging if it is safe to cross the road, or who is trustworthy
- difficulties with concentration and attention
- loss of interest in activities they used to enjoy
- difficulties with visual perception, for example perceiving a dark coloured rug to be a hole in the ground
- sundowning – a state of intense confusion and anxiety that typically occurs later in the day, around dusk
Communication issues
People with dementia may experience problems with communicating and understanding, including:
- struggling to find the right words
- calling people and items by the wrong name
- repeating themselves often; telling the same stories repeatedly
- difficulty making and following conversation
- confused or rambling speech
- difficulty reading and writing
- becoming quieter and more withdrawn
- difficulties with numeracy, including understanding and using money
- loss of interest in socialising because of their communication difficulties
Changes in behaviour and personality
Changes in behaviour and personality are more common in people with some forms of dementia. You may notice the person:
- becomes agitated, upset or impatient more easily than usual
- acts impulsively or in ways that are socially inappropriate, such as staring at people, swearing or making personal comments
- seems anxious or depressed, or has mood swings
- shows repetitive or obsessive behaviour, such as repeating actions, gestures or words
- experiences restlessness, for example pacing, fidgeting and trying to leave the house for no obvious reason
- has changes in eating and drinking habits, such as an increased or reduced appetite, disliking foods they previously enjoyed, overeating or forgetting to eat
- experiences changes in sleep patterns, for example struggling to get to sleep, waking during the night or sleeping more during the day
- becomes particularly confused and distressed later in the day, especially around dusk – known as sundowning
- becomes withdrawn and less interested in family, friends and socialising
Early signs of dementia
In the early stages of dementia, people typically start to experience symptoms that affect their everyday living, including:
- problems with memory and concentration
- difficulties with language and communication, such as finding the right words and following conversations
- difficulties with planning, problem-solving and decision-making
- getting lost in familiar places due to problems with orientation and a loss of recognition of cues that they usually rely on, such as signs and landmarks
- changes in behaviour and personality, for example becoming less patient or more withdrawn
- low mood, anxiety or depression
The person with early symptoms of dementia may notice the signs themselves, or family, friends and colleagues may spot them first.
Memory problems may not be obvious in the early stages of some types of dementia, like frontotemporal dementia – changes in behaviour and personality may develop first. People with young onset dementia (where symptoms develop before the age of 65) are also less likely to experience memory loss as an early symptom.
How do the early symptoms of dementia progress?
Because dementia is progressive, the signs and symptoms will become more obvious and have a bigger impact on the person’s daily life over time. Some people’s dementia progresses rapidly, while for others, the changes happen more slowly over the course of months or years.
In the middle stages of dementia, a person might:
- have increasing problems with memory, even in types of dementia where memory loss is less of an issue in the early stages
- struggle more with communication, including word-finding, understanding sounds and holding conversations
- become disinhibited in their speech and actions, for example swearing; being too intimate with other people
- have delusions and false beliefs, for example thinking someone is stealing from them
- experience hallucinations, most commonly visual (seeing things that are not there) or auditory (hearing things that are not there)
- become increasingly disorientated in place or time, for example not recognising they are at home or thinking they need to pick their child up from school even if they are now an adult
- have changes in sleep habits, for example insomnia or increasing sleepiness during the day
As the symptoms of dementia progress, the person is likely to need more support with daily living, such as washing, dressing, eating and maintaining their home.
Late stage dementia symptoms
In the later stages of dementia, the person’s symptoms will become more pronounced and they are likely to need support with everything they do. A person with advanced dementia is likely to:
- have significant difficulties with communication; many people eventually lose the ability to communicate verbally
- become increasingly disorientated in time and place, which may cause significant distress
- have difficulty recognising their partner, children, family members or friends
- experience increasing distress and confusion, which they may show by crying, pacing, shouting or following a family member around
- have mobility issues and an increased risk of falls – some people will need to use a wheelchair and may eventually spend most of their time in bed
- have difficulties with eating, drinking and swallowing
- become increasingly frail
- be more vulnerable to infections and find it harder to recover from illness or injury
- sleep a lot more
- experience incontinence
Many people with dementia will eventually need additional care from a home carer or in a residential care home.
A sudden worsening in dementia symptoms
The progression of dementia can be unpredictable. A person’s symptoms may remain stable for some time and then suddenly worsen, or they may progress gradually.
It is important not to assume that a sudden change in symptoms is a result of the person’s dementia. There may be an underlying medical condition such as an infection or delirium (a state of sudden, intense confusion that is often linked to illness). If there is a noticeable change in the person’s symptoms – such as increasing distress, confusion, hallucinations or frequent falls – it is important to seek advice from their GP.
Symptoms specific to types of dementia
Symptoms of Alzheimer’s disease
Common signs and symptoms of Alzheimer’s disease include:
- difficulty remembering recent events while having a good memory for past events
- poor concentration
- difficulty recognising people or objects
- poor organisational skills
- confusion
- disorientation
- slow, muddled or repetitive speech
- withdrawal from family and friends
- problems with decision-making, problem-solving, planning and following steps in tasks
Symptoms of vascular dementia
Vascular dementia is caused by problems with blood flow to the brain, for example as a result of a stroke or ‘mini strokes’ known as transient ischaemic attacks (TIAs). The signs and symptoms depend on which area of the brain has been affected. Common symptoms include:
- difficulty with concentration and attention
- difficulty with planning and decision-making
- slowed thought processes
- changes in mood, behaviour and personality
- difficulties with communication and understanding, including language, reading and writing
- short-term memory problems – although these are less common in the early stages than in other types of dementia, like Alzheimer’s disease
Symptoms of frontotemporal dementia
There are two main types of frontotemporal dementia: behavioural variant frontotemporal dementia (bvFTD) and primary progressive aphasia (PPA).
The initial symptoms of bvFTD may include:
- reduced motivation and loss of interest in things the person used to enjoy
- inappropriate behaviour, eg staring, making suggestive comments, invading people’s personal space
- loss of empathy
- difficulty with concentration and attention
- obsessive or repetitive behaviour, eg repeating words or gestures, hoarding
- changes in taste and appetite, eg overeating, craving sweet foods, drinking too much alcohol
- difficulty with planning, organising and decision-making
- lack of awareness of the changes in themselves (lack of insight)
The initial symptoms of PPA include:
- difficulty remembering, finding or understanding words, forming sentences and using grammar correctly
- gradual loss of vocabulary
- forgetting what common objects are and what they do, eg kettle, toaster, keys
- difficulty holding conversations, for example stopping speaking mid-sentence as they search for the right word
Symptoms of Lewy body dementia
The symptoms of Lewy body dementia include:
- recurring visual hallucinations (seeing things that are not there)
- disturbed sleep, including restlessness and intense dreams/nightmares
- fluctuations in alertness – the person may stare into space, seem lethargic and spend a lot of time sleeping
- slow movement, difficulty walking, shuffling, or appearing rigid
- tremors – usually in the hands
- problems with balance, leading to falls
- difficulties with continence
- difficulties with swallowing
- mood changes, such anxiety and depression
- delusions and paranoia
- changes in body temperature
- impaired sense of smell
Memory is often less affected than in other types of dementia.
Symptoms of mixed dementia
Mixed dementia refers to a person having more than one type of dementia at the same time. They will have symptoms of each type, which may be more noticeable and appear to progress more rapidly.
Symptoms of Huntington’s disease
Huntington’s disease is a genetic condition that primarily affects a person’s movement. It is not in itself dementia, but the damage it causes to the brain may lead to dementia. You can find out more about the physical, mental and cognitive symptoms in our information on Huntington’s disease.
Symptoms of Parkinson’s dementia
Parkinson’s primarily affects people’s movement, with symptoms including slow movement, tremors, rigidity and balance problems. About one-third of people with Parkinson’s will go on to develop dementia, known as ‘Parkinson’s with dementia’, particularly in the later stages. Please see our information on Parkinson’s and Parkinson’s with dementia.
Symptoms of alcohol-related brain damage and alcohol-related dementia
There are two main types of alcohol-related brain damage: Wernicke’s encephalopathy and Korsakoff’s syndrome.
Alcohol-related brain damage is often reversible if the person stops drinking alcohol and receives thiamine (vitamin B1) supplementation. However, it can develop into dementia, which is known as ‘alcoholic dementia’. The symptoms of alcoholic dementia include:
- difficulty with planning, decision-making and assessing risk
- changes in personality
- poor control of impulses and emotions, such as socially inappropriate behaviour
- problems with attention, concentration and memory
Symptoms of dementia in men vs women
Dementia symptoms are generally the same in men and women. However, women are more likely to develop Alzheimer’s disease than men, which has symptoms like memory loss, confusion and loss of recognition of people, places and objects.
Men are slightly more likely than women to develop vascular, frontotemporal and Lewy body dementia, so may show the symptoms most commonly associated with these types, such as difficulties with communication, attention and decision-making; and changes in behaviour and personality.
Age-related dementia symptoms
While dementia itself is not a normal part of ageing, the risk of developing dementia increases with age. In general, the symptoms of dementia are similar in both younger and older people, but they may seem more pronounced in older people.
People with young onset dementia are more likely to have a rarer form of dementia with less typical symptoms. This may mean that their dementia symptoms are missed or misdiagnosed.
What conditions can cause symptoms similar to dementia?
Several conditions cause symptoms similar to those of dementia. These include:
- head injuries
- perimenopause/menopause
- depression
- some infections, such as urinary tract infections (UTIs)
- vitamin deficiencies, particularly vitamin B12
- malnutrition
- problems with hearing or vision
